Systems and methods for surgical guide for real-time MRI surgery

Abstract

A system and method are provided for a guide system for guiding an interventional medical instrument toward a region of interest (ROI) along a predetermined trajectory path. The guide system comprises a base, an adjustment ring, and a plurality of guide blocks. The adjustment ring is configured to be selectively fixed in one of a plurality of rotational orientations with respect to the base. The plurality of guide blocks are each configured to be selectively fixed in one of a plurality of rotational orientations with respect to the adjustment ring and each include a guide hole. Each of the plurality of guide blocks include at least one of differing angles of trajectory or differing locations of the guide hole from others of the plurality of guide blocks to provide a selectable, predetermined location of the guide hole and angle of trajectory.

What is claimed is: 
     
       1. A guide system for guiding an interventional medical instrument toward a region of interest (ROI) along a predetermined trajectory path, the guide system comprising:
 a base configured to be attached to a subject proximate to the ROI; 
 an adjustment ring configured to be selectively fixed in one of a plurality of incremental rotational orientations with respect to the base; and 
 a plurality of guide blocks, wherein each guide block of the plurality of guide blocks is configured to be selectively fixed in one of a plurality of incremental rotational orientations with respect to the adjustment ring, and wherein each guide block includes a central axis and a guide hole configured to guide the interventional medical instrument therethrough along an angle of trajectory with respect to the central axis of the corresponding guide block; 
 wherein each of the plurality of guide blocks includes at least one of differing angles of trajectory or differing locations of the guide hole from others of the plurality of guide blocks to provide a selectable, predetermined location of the guide hole and angle of trajectory when a given guide block of the plurality of guide blocks is received in the base. 
 
     
     
       2. The guide system of  claim 1 , further comprising:
 a plurality of ring adjustment controls configured to selectively fix the adjustment ring in a desired rotational orientation with respect to the base; and 
 a plurality of block adjustment controls configured to selectively fix the guide block in the desired rotational orientation with respect to the adjustment ring. 
 
     
     
       3. The guide system of  claim 2 , wherein the plurality of ring adjustment controls comprises a plurality of locating notches and a corresponding plurality of locating protrusions, wherein the plurality of locating notches are arranged on a ring holder that is coupled to the base and wherein the plurality of locating protrusions are arranged on the adjustment ring and are configured to engage the plurality of locating notches. 
     
     
       4. The guide system of  claim 2 , wherein the plurality of ring adjustment controls comprises a plurality of alignment holes arranged on the base and a corresponding alignment tab arranged on the adjustment ring and configured to engage a predetermined one of the plurality of alignment holes. 
     
     
       5. The guide system of  claim 2 , wherein the plurality of block adjustment controls comprises a plurality of locating notches and a corresponding plurality of locating protrusions, wherein the locating notches are arranged on the adjustment ring, and the plurality of locating protrusions are arranged on each of the plurality of guide blocks and are configured to engage the plurality of locating notches. 
     
     
       6. The guide system of  claim 2 , wherein the plurality of block adjustment controls comprises a plurality of alignment holes arranged on the adjustment ring and a corresponding alignment tab arranged on the guide block and configured to engage a predetermined one of the plurality of alignment holes. 
     
     
       7. The guide system of  claim 2 , wherein the plurality of ring adjustment controls provides a first prime number of unique adjustment ring rotational orientations with respect to the base, and wherein the plurality of block adjustment controls provides a second prime number of unique guide block rotational orientations with respect to the adjustment ring, and wherein the first prime number is different than the second prime number. 
     
     
       8. The guide system of  claim 7 , wherein the plurality of ring adjustment controls provides seventeen unique adjustment ring rotational orientations with respect to the base and the plurality of block adjustment controls provides thirteen unique guide block rotational orientations with respect to the adjustment ring. 
     
     
       9. The guide system of  claim 2 , further comprising a plurality of indicators configured to indicate an orientation of the adjustment ring with respect to the base for each of the plurality of ring adjustment controls. 
     
     
       10. The guide system of  claim 9 , wherein the plurality of indicators are arranged on one of the base and the adjustment ring and the other of the base and the adjustment ring includes an alignment marker configured to be aligned with a predetermined one of the plurality of indicators to arrange the adjustment ring in the desired rotational orientation with respect to the base. 
     
     
       11. The guide system of  claim 2 , further comprising a plurality of indicators configured to indicate an orientation of the guide block with respect to the adjustment ring for each of the plurality of block adjustment controls. 
     
     
       12. The guide system of  claim 11 , wherein the plurality of indicators are arrange on one of the guide block and the adjustment ring and the other of the guide block and the adjustment ring includes an alignment marker configured to be aligned with a predetermined one of the plurality of indicators to arrange the guide block in the desired rotational orientation with respect to the adjustment ring. 
     
     
       13. The guide system of  claim 1 , wherein the base includes a plurality of stilts configured to couple the base to the subject. 
     
     
       14. The guide system of  claim 1 , wherein the base includes a flange having a curved lower surface configured to conform to a surface of a skull of the subject. 
     
     
       15. The guide system of  claim 1 , wherein each of the plurality of guide blocks includes a corresponding integral trajectory stem configured to effectively elongate the corresponding guide hole. 
     
     
       16. A guide system for guiding an elongated medical instrument toward a region of interest along a predetermined trajectory path, the guide system comprising:
 a base configured to be attached to a subject to receive the elongated medical instrument during an interventional medical procedure; 
 an adjustment ring engaging the base; 
 a plurality of ring adjustment controls configured to selectively fix the adjustment ring in a desired rotational orientation with respect to the base; 
 a plurality of guide blocks, wherein each guide block of the plurality of guide blocks includes a central axis and a guide hole configured to guide the elongated medical instrument therethrough along an angle of trajectory with respect to the central axis of the corresponding guide block and into the subject to perform the interventional medical procedure, wherein the guide holes of the plurality of guide blocks provide at least one of a different angle of trajectory or a different location within a given guide block; 
 a plurality of block adjustment controls configured to selectively fix the given guide block in a desired rotational orientation with respect to the adjustment ring to present at least one of a unique angle of trajectory or location of the guide hole through which to receive the elongated medical instrument during the interventional medical procedure. 
 
     
     
       17. The guide system of  claim 16 , wherein the plurality of ring adjustment controls provides a first prime number of unique adjustment ring rotational orientations with respect to the base and the plurality of block adjustment controls provides a second prime number of unique guide block rotational orientations with respect to the adjustment ring, and wherein the first prime number is different than the second prime number. 
     
     
       18. The guide system of  claim 16 , further comprising a plurality of indicators disposed on at least one of the base and the adjustment ring and configured to indicate an orientation of the adjustment ring with respect to the base. 
     
     
       19. The guide system of  claim 16 , further comprising a plurality of indicators disposed on at least one of the adjustment ring or the guide block and configured to indicate an orientation of the guide block with respect to the adjustment ring. 
     
     
       20. The guide system of  claim 16 , wherein the guide system is composed of material or materials that is safe for use within a magnetic resonance imaging (MRI) system. 
     
     
       21. A guide system for guiding an interventional medical instrument toward a region of interest (ROI) along a predetermined trajectory path, the guide system comprising:
 a base configured to be attached to a subject proximate to the ROI; 
 an adjustment ring configured to be selectively fixed in one of a plurality of incremental rotational orientations with respect to the base; 
 a plurality of detachable trajectory stems, each having a guide hole; and 
 a plurality of guide blocks, each guide block configured to be selectively fixed in one of a plurality of incremental rotational orientations with respect to the adjustment ring and including a central axis and a trajectory stem aperture, the trajectory stem aperture being configured to receive a given detachable trajectory stem of the plurality of detachable trajectory stems and orient the corresponding guide hole of the given detachable trajectory stem along an angle of trajectory with respect to the central axis of the corresponding guide block; 
 wherein each of the plurality of guide blocks includes at least one of differing angles of trajectory or differing locations of the guide hole from others of the plurality of guide blocks to provide a selectable, predetermined location of the guide hole and angle of trajectory when a given guide block of the plurality of guide blocks is received in the base, 
 wherein the plurality of detachable trajectory stems each include a connection portion configured to selectively couple the given detachable trajectory stem to the given guide block. 
 
     
     
       22. The guide system of  claim 21 , wherein the guide holes of each of the plurality of detachable trajectory stems have a guide hole diameter, and each of the plurality of detachable trajectory stems includes a differing guide hole diameter from others of the plurality of detachable trajectory stems to provide a selectable, predetermined clearance diameter for the interventional medical instrument when the given detachable trajectory stem is received in the trajectory stem aperture of the given guide block. 
     
     
       23. The guide system of  claim 21 , wherein the connection portion of the given detachable trajectory stem and the trajectory stem aperture of the given guide block each include teeth configured to engage each other to selectively couple the given detachable trajectory stem to the given guide block. 
     
     
       24. The guide system of  claim 21 , wherein the connection portion of the given detachable trajectory stem includes a plurality of pegs and the trajectory stem aperture of the given guide block includes a corresponding plurality of slots configured to receive the plurality of pegs to selectively couple the given detachable trajectory stem to the given guide block. 
     
     
       25. The guide system of  claim 21 , wherein the connection portion of the given detachable trajectory stem includes a locking ring and the trajectory stem aperture of the given guide block includes a corresponding ring slot configured to receive the locking ring to selectively couple the given detachable trajectory stem to the given guide block. 
     
     
       26. The guide system of  claim 21 , wherein the trajectory stem aperture of the given guide block includes a set of grooves and the connection portion of the given detachable trajectory stem includes a set of movable teeth configured to selectively engage the set of grooves of the given guide block to selectively couple the given trajectory stem to the given guide block.